从"以病人为中心"到"以人为中心"--北京大学深圳医院用创新理念引导创新经营的做法和成效

从“以疾病为中心”、“以医生为中心”到“以病人为中心”是医院服务或经营理念的重大突破。随着经济和社会的发展，病人与健康人，以及健康的概念已逐步发生变化。人人拥有健康已成为21世纪现代人的美好企盼。有鉴于此，我们在健康经济学理论研究的基础上，率先提出“以人为中心”的全新理念，并以创新理念引导创新经营，进一步提出“健康产业”的全新概念。近3年来，在医院内尝试推行全新的健康服务新模式。介绍了新理念产生的背景、内涵、以及创新经营的做法和成效。     

耐多药结核病患者"知""信""行"护理干预模式研究

目的评价耐多药结核病患者“知、信、行”护理干预模式的效果。方法将60例耐多药结核病患者随机分成研究组和对照组各30例,对照组采用规则抗结核治疗和常规护理,研究组实施“知、信、行”护理干预。结果研究组知识、信念、行为明显高于对照组;12个月痰菌阴转率为83．3％、患者病灶吸收率81．3％、空洞闭合率55．6％,明显高于对照组;二者与对照组比较差异有显著意义。结论采用“知、信、行”护理干预模式,能有效地提高耐多药结核病患者的治疗疗效,改善其生活质量。     

Thoughts on "defensive" medicine

"Defensive" medicine is called medical behaviour characterized by deformation of diagnostic and therapeutic activities due to fears endangering existence and work, thus some interventions are omitted or, on the contrary, superfluous examinations are proposed on account of internal uncertainty, the patient's distrust or hostile social environment. Trust relation between patient and physician is the most gravely damaged because of aggravation and distortion of some conscienceless physicians' abuses by the media; patient-physician relations may not be degraded to contractual legal relations. Young physicians must get acquainted with the joy of success in diagnostics that enriches the personality. They shall have healthy self-esteem and be ready to take diagnostic and therapeutic challenges on themselves. All of us have to fight against social atmosphere hostile to physicians, against causes inducing and augmenting practice of defensive medicine.     

试论“民本卫生”与“和谐卫生”

构建“民本卫生、和谐卫生”是深入学习党的十七大精神、贯彻科学发展观所提出来的卫生发展思想，对破解当前卫生发展中的难题、开创卫生工作新局面有重要意义。构建民本卫生、和谐卫生必须重点把握理论和实践、守业与创业、公平与效率、局部和全局、当前和长远、突出重点与整体推进、尽力而为与量力而行、政府主导与社会参与等8个方面的关系。     

病例同胞对照设计

目的介绍病例同胞对照设计的研究设计及统计分析方法,并对实际资料进行统计分析.方法以亚甲基四氢叶酸还原酶基因C677T突变与冠心病连锁研究为实例,采用同胞-传递不平衡检验（s-TDT）和同胞组不平衡检验（SDT）等方法进行统计分析.结果采用s-TDT分析,统计量Z=0.27,P〉0.05;采用SDT分析,x^2=0.31,P〉0.05.提示受累子代与非受累子代T等位基因分布差异无统计学意义.结论病例同胞对照设计使用患者同胞作为对照,避免了人群分层现象,可以用来检测基因与疾病之间的关联或连锁.     

Symbolism on "natural" in food

The incorporated senses represent a set of possibilities for future life able to build individual and collective identities. This work deepens the habitus, in Bourdieu's terms, associated with "natural" and fast-food styles, making an interpretative analysis of symbolic exchanges of elements reproduced in feeding practices. We believe that this bricolage arrangement of elements enables bartering and hybridism, marked by a tension that reflects the insecurity of technological innovations. The "natural" style represents an ideal of self-sustainability, non-polluting production, which faces the sanitary and ecologic crisis of the planet, against the large-scale industrialization and fast urbanization, defined as depredation factors of basic living conditions. The exchanges happen in a symbolic game connected with the global economic game, in which social actors make bets, illusio, according to particular intentions in concrete action. There is a chance to reformulate the rules of the game in the "game", although with a precarious balance of forces, in which the weaker side loses, an agent may have the possibility of not reproducing the pressures of globalized feeding, which is far from what might seem supernatural.     

Reflections on "making somebody angry"

This article presents an account of the methodological and ethical issues associated with a critical ethnographic study that focused on the problems of providing nondiscriminatory health care to people with HIV/AIDS. The focus is on the debates that followed the publication of the final report. The debates were centered around (a) formal objections by the chair of the institutional ethics committee to the standard procedure of a discussion of the methodological limitations imposed by the requirements of the conditions of access; (b) reactions by a small section of the medical profession to adverse findings, which were published in a professional medical journal and included an attack on both the methods used and the ethics of the researchers; and (c) the response of the media, which selectively sensationalized and distorted the findings. This discussion may provide further insight into the problems of gaining access to clinical settings for the purpose of conducting qualitative research.     

重“三基”抓“三严”提高护理服务质量

“三基”即基本理论、基本知识、基本技能,“三严”即严格要求、严密组织、严谨态度。“三基”水平的高低是衡量一个医院护理人员业务素质和护理技术水平的重要内容,也是当前医院质量评审的重点。“三严”管理则是实施”三基”训练的必要保证,是一种科学的管理方法。     

医疗机构“存量资源委托管理”探索

区域卫生规划外的医疗机构"存量资料"的重组,对探索区域卫生规划的实施与深化卫生改革具有实践意义,用SWOT分析法制订改革策略,用法定的程序规范改革的动作,采用"委托管理"模式探索管办分开的有效形式,从而实践公立医院"过剩资源"重组。     

Comment on "Alternative Medicare financing sources"

Restoring the reality of a budget constraint in the health care plans of all patients and providers--not only in the Medicare program--is the most important issue of domestic social policy in the remainder of this century. There is no case for major new earmarked taxes to "fix" Medicare unless they are elements of an overall tax structure adequate to pay for the expenditures which our political process deems necessary.     

Toxicity Studies on "840 Biologic Pesticide"

[Objective] "840 Biologic Pesticide" is a very effective biologic pesticide. It consists of Abamectin and celastrus angulatus. Toxicity study was aimed to provide scientific toxicological basis. [Methods] The acute toxicity test,Ames test,micronucleus test and testicle chromosome aberration test were done. [Results] The acute toxicity of single dose of "840 Biologic Pesticide" showed that acute oral LD50 for female and male rats are 4 300 and 4 280 mg/kg,and for female and male mice are 2 330 and 5 110 mg/kg,respectively. The dermal LD50 was ＞2 000 mg/kg for female and male rats. The mutagenesis studies indicated that Ames test,micronucleus test and testicle chromosome aberration test were negative. [Conclusion] Tested pesticidc belongs to low toticity grade.